Asymptomatic/Low Risk HTN
Low Risk HTN, no labs
VS notable for hypertension. No complaints of CP, SOB, and pain, neurologic symptoms to indicate end-organ damage. The patient reports being asymptomatic otherwise. Long term risk/benefits of controlling elevated blood pressure were discussed. Per the ACEP clinical policy, the patient’s BP is elevated, but risk of lowering BP acutely could result in increased morbidity/mortality, and this was discussed with the patient. The patient will follow with their PCP this week or find a new PCP to consult about the long term management of their hypertension. They understand to return immediately for any new or worsening symptoms such as HA, chest pain, dyspnea, numbness/tingling/weakness, or anything that makes them question their wellbeing.
Medication Prescribed: []
Low Risk HTN, labs
VS notable for hypertension. No complaints of CP, SOB, and pain, neurologic symptoms to indicate end-organ damage. The patient reports being asymptomatic otherwise. Long term risk/benefits of controlling elevated blood pressure were discussed. Per the ACEP clinical policy, the patient’s BP is elevated, but risk of lowering BP acutely could result in increased morbidity/mortality, and this was discussed with the patient. Per ACEP guidelines given the degree of BP elevation and social determinants/clinical picture, will obtain BMP to assess renal function for EOD. No indication for further testing at this time.
Re-exam, Normal/DC
Labs without evidence of end-organ damage. Patient still asymptomatic. Discharging with instructions for closes PCP followup and possibly start on low-dose antihypertensive per JNC recommendations. I discussed this with the patient and they agree with the plan of care. They understand to return immediately for any new or worsening symptoms such as HA, chest pain, dyspnea, numbness/tingling/weaknes, or anything that makes them question their wellbeing.
Medication Prescribed: []
Charting Tips
- Markedly elevated hypertension has a wide variety of management approaches. Here is the link to the ACEP clinical policy which shaped our MDM. –ACEP Clinical Policy on Asymptomatic Hypertension